Оглавление
Группа авторов. The Veterinary Dental Patient: A Multidisciplinary Approach
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
The Veterinary Dental Patient. A Multidisciplinary Approach
List of Contributors
Preface
Acknowledgments
About the Companion Website
1 Establishing a Dental Presence within a General Veterinary Practice
1.1 Introduction
1.2 General Considerations: How to Begin Offering Dentistry
1.3 Education
1.4 Promotion
1.5 Equipment Considerations. 1.5.1 Waiting Room
1.5.2 Consulting Room
1.6 Dental Operatory
1.7 Ergonomy, Organization, and Functionality
1.8 How to Choose the Proper Equipment
1.9 Power Dental Equipment
1.10 Dental Instrumentation
1.10.1 Diagnostic Kit
1.10.2 Surgical Kit
1.10.3 Periodontal Kit
1.10.4 Instrument Care and Sharpening
1.10.5 Materials Required
References and Further Reading
2 Marketing and Communication in Veterinary Dentistry
2.1 Introduction
2.2 Compliance
2.3 To Sell Is Human
2.4 Making Persuasive Recommendations
2.4.1 Trust
2.4.2 Empathy
2.4.3 Logic
2.5 Communication Skills
2.5.1 Nonverbal Communication
2.5.2 Open‐Ended Questioning
2.5.3 Reflective Listening
2.5.4 Displays of Empathy
2.6 Marketing Dental Services
2.7 Conclusion
References
3 Teaching Veterinary Dentistry
3.1 Introduction
3.2 Veterinary Dentistry in Europe's University Curricula
3.3 How Is Veterinary Dentistry Taught in Universities? What Is Missing?
3.4 Veterinary Dental Education Today
3.5 Examples of Teaching
3.6 Student Chapters
3.7 Postgraduate Education and Specialization
3.8 Veterinary Dental Specialists
3.9 Veterinary Dental Education in the Future
References
4 Distribution of Tasks Around the Dental Patient in General Practice : Receptionists, Technicians, and Other Veterinary Team Members
4.1 Introduction
4.2 Receptionists
4.3 Kennel Assistants
4.4 Veterinary Care Assistants
4.5 Credentialed Veterinary Technicians/Nurses
4.5.1 History Gathering
4.5.2 Oral Examination: The Conscious Patient
4.5.3 Treatment Plan
4.5.4 Oral Examination: The Anesthetized Patient
4.5.5 Professional Dental Cleaning
4.5.6 Home Care Instructions
4.6 Veterinarians
4.7 Pet Owners
4.8 Conclusion
References
5 Prophylactic Program for Oral Health
5.1 Introduction
5.2 Regular Dental Examinations (and cleanings)
5.3 Established Regular Oral Home Care. 5.3.1 Importance of Home Dental Care
5.3.2 Client Discussion/Instruction
5.3.3 Goals of Home Plaque Control
5.3.4 Types of Home Care
5.3.4.1 Active Home Care
5.3.4.1.1 Tooth Brushing
5.3.4.1.2 Materials and Methods
5.3.4.1.3 Brushing Technique
5.3.4.1.4 Antiseptic Rinses
5.3.4.1.5 Barrier Sealant
5.3.4.2 Passive Home Care
5.3.4.2.1 Tartar‐Control Diets
5.3.4.2.2 Dental Treats and Chews
5.3.4.2.3 Water Additives
5.3.4.2.4 Probiotics
5.3.4.2.5 Fatty Acids
5.3.4.2.6 Other Supplements
5.4 Conclusion
References
Notes
6 Nutrition, Oral Health, and Feeding Dental Patients
6.1 Introduction
6.2 Modifications of the Oral Cavity Microbiome
6.2.1 Canine Oral Cavity Microbiome
6.2.2 Feline Oral Cavity Microbiome
6.3 Current Nutritional Strategies for Oral Microflora Modification. 6.3.1 Targeting Specific Bacteria
6.3.2 Modification of Saliva Composition
6.3.3 Antibacterial Ingredients in Nutritional Products
6.4 Elimination of Dental Plaque by Nutritional Products
6.5 Inhibition of Calculus Formation
6.6 Veterinary Oral Heath Council Seal of Acceptance
6.7 Role of Chewing in Passive Hygiene
6.8 Conclusion
References
7 Antimicrobials in Veterinary Dentistry
7.1 Introduction
7.2 Oral Microbiota of Dogs and Cats
7.3 Antimicrobial Use in Human Dentistry
7.3.1 Prevention of Infective Endocarditis
7.3.2 Prevention of Extra‐Oral Implant Infections
7.3.3 Prevention of Oral Infections
7.4 Antimicrobials in Veterinary Dentistry
7.4.1 Treatment of Oral and Dental Infections
7.4.2 Prevention of Oral Infections Associated with Dental Procedures
7.4.3 Prevention of Bacteremia and Infective Endocarditis
7.5 Prophylaxis for Patients with Orthopedic Implants
7.6 Periodontal Disease Control
7.7 Plaque Control
7.8 Infection Control
7.8.1 Personal Protective Equipment
7.8.2 Hand Hygiene
7.8.3 Facility Design
7.8.4 Sharps Handling
7.8.5 Environmental Cleaning and Disinfection
7.8.6 Pre‐Procedure Biocide Mouth Rinse
7.8.7 Equipment Cleaning, Disinfection, and Sterilization
7.8.8 Instrument Pack Handling
7.8.9 Intraoperative Patient Management
7.8.10 Surgical Antisepsis
7.8.11 Surveillance
7.8.12 Zoonotic Infections
References
8 Dental Patient Welfare
8.1 Introduction
8.2 What Is Animal Welfare?
8.3 Modern Animal Welfare Needs Assessment
8.4 Five Freedoms and Five Animal Welfare Needs
8.5 Measuring Quality of Life
8.6 Prevalence of Dental Disease
8.7 Dental Disease Associations with Compromised Animal Welfare Needs
8.8 Physiological Signs of Stress
8.9 Behavior Changes
8.10 Client Education Matters
8.11 Welfare Issues Surrounding the Veterinary Visit, Handling Techniques, and Procedural Design
8.12 Welfare Implications ofAnesthesia‐Free Dentistry
8.13 Economic Consequences of Improved Welfare Outcomes
8.14 Conclusion
References
9 Local, Regional, and Systemic Complications of Dental Diseases
9.1 Introduction
9.2 Oral Health Impacts General Health
9.3 Oronasal Communication/Fistulas
9.4 Periapical Lesions
9.5 Pathologic Fracture
9.6 Ocular Damage
9.7 Oral Cancer
9.8 Osteomyelitis
9.9 Systemic Complications of Oral Diseases
9.10 Conclusion
References
10 Hereditary Oral Disorders in Purebred Dogs and Cats
References
11 Pain Management in the Dental Patient
11.1 Introduction
11.2 Impact of Oral Disease and Pain on Nutrition/Food Intake and Quality of Life
11.3 Present and Future Challenges in Pain Management for the Veterinary Dental Patient
11.4 Physiology of Pain
11.5 Dental Nociception, Inflammation, and Hypersensitivity
11.6 Causes of Dental and Orofacial Pain
11.7 Assessment and Recognition
11.8 Treatment
11.8.1 Opioids
11.8.2 Partial μ‐Opioid Agonist/κ‐Antagonists
11.8.3 Partial μ‐Opioid Agonist/Partial κ‐Agonists
11.8.4 Opioid Antagonists
11.8.5 Anti‐Inflammatory Drugs. 11.8.5.1 NSAIDs
11.8.5.2 EP4 Receptor Antagonists
11.8.5.3 Corticosteroids
11.8.5.4 Other Drugs with Analgesic and Potential Anti‐Inflammatory Effects
11.8.6 Local Anesthetics
11.8.6.1 Pharmacology
11.8.6.2 Adjuncts
11.8.6.2.1 Catecholamines
11.8.6.2.2 Alpha‐2 Agonists
11.8.6.2.3 Opioids
11.8.6.2.4 Dexamethasone
11.8.6.3 Regional Techniques
11.8.6.3.1 Inferior Alveolar Nerve Block
11.8.6.4 Middle Mental Canal Injection
11.8.6.5 Infraorbital Block
11.8.6.6 Maxillary Nerve Block
11.8.6.7 Palatine Block
11.8.7 Systemic Lidocaine
11.8.8 Ketamine
11.8.9 Amantadine
11.8.10 Gabapentin
11.8.11 Mesenchymal Cells in Cats
11.8.12 Maropitant
References
12 Anesthesia of the Dental Patient
12.1 Introduction
12.2 Anesthesia Record Keeping
12.3 Patient History and Physical Examination
12.4 Basic Laboratory Testing
12.5 Anesthetic Management. 12.5.1 Premedication
12.5.2 Selection of Drugs for Premedication. 12.5.2.1 Suppression of Vomiting
12.5.2.2 Anticholergics
12.5.2.3 Mild to Moderate Tranquilizers
12.5.2.4 Sedative Analgesics
12.5.2.5 Moderate to Heavy Sedatives
12.5.3 Creating Pre‐Anesthetic Protocols
12.5.4 Intravenous Catheter Placement and Fluid Support
12.5.5 Pre‐Induction Support
12.5.6 Anesthesia Induction
12.5.7 Inhalant Anesthetic Maintenance
12.5.8 MAC Sparing Techniques
12.5.9 Maropitant (Cerenia)
12.5.10 Midazolam CRI
12.5.11 Monitoring Patient Physiology. 12.5.11.1 Noninvasive Arterial Blood Pressure
12.5.11.2 Electrocardiogram
12.5.11.3 Monitoring Ventilation
12.5.12 Pulse Oximetry
12.5.12.1 Hypothermia
12.5.13 Anesthetic Recovery
12.6 Special Patient Presentations. 12.6.1 Geriatric Patients
12.6.2 Obesity
12.6.3 Cardiac Compromise
12.6.4 Diabetes Mellitus
12.6.5 Renal Disease
12.6.6 Hepatic Dysfunction
References
13 The Dental Patient and Its General Conditions : Cardiac Disease, Diabetes Mellitus, Pregnancy, History of Seizures, and Brachycephalic Syndrome
13.1 Patients with Cardiac Disease
13.2 Dilated Cardiomyopathy in Dogs. 13.2.1 Preoperative Considerations
13.3 Mitral Valve Insufficiency in Dogs. 13.3.1 Preoperative Considerations
13.3.2 Sedation
13.3.3 Induction of Anesthesia
13.3.4 Maintenance Phase
13.3.5 Recovery and Postoperative Management
13.4 Hypertrophic Cardiomyopathy in Cats. 13.4.1 Preoperative Considerations
13.4.2 Sedation
13.4.3 Induction of Anesthesia
13.4.4 Maintenance Phase
13.4.5 Recovery and Postoperative Management
13.5 Patients with Diabetes Mellitus. 13.5.1 Preoperative Considerations
13.5.2 Anesthetic Management
13.5.3 Perioperative Management
13.5.4 Recovery and Postoperative Management
13.6 Pregnant Patients. 13.6.1 Preoperative Considerations
13.6.2 Anesthetic Management
13.6.3 Perioperative Management
13.6.4 Recovery and Postoperative Management
13.7 Patients with a History of Seizures. 13.7.1 Preoperative Considerations
13.7.2 Sedation
13.7.3 Induction of Anesthesia
13.7.4 Maintenance Phase
13.7.5 Recovery and Postoperative Management
13.8 Brachycephalic Patients. 13.8.1 Preoperative Considerations
13.8.2 Sedation
13.8.3 Induction of Anesthesia
13.8.4 Maintenance Phase
13.8.5 Recovery and Postoperative Management
References
14 Ophthalmic Considerations in the Veterinary Dental Patient
14.1 Introduction
14.2 Ophthalmic Manifestations of Dental Disease
14.3 Maxillofacial Trauma
14.4 Ophthalmic Care During Dental Surgery
14.5 Combined Oral and Ocular Surgery Considerations
14.6 Conclusion
References
15 Oral Health in the Context of Other Planned Surgeries
15.1 Introduction
15.2 Pathways Linking Oral Disease to Remote Locations
15.2.1 Bacteremia
15.2.2 Entotoxins
15.2.3 Immunological Injury
15.2.4 Impact on Other Organs
15.3 Guidelines for the Veterinarian. 15.3.1 Classification Systems. 15.3.1.1 Dental Procedures
15.3.1.2 Other Planned Surgeries (Established Classification)
15.3.2 Considerations
15.3.3 Recommendations
References
16 Systemic Diseases Influencing Oral Health and Conditions
16.1 Introduction
16.2 Genetic and Developmental Disorders
16.3 Systemic Diseases. 16.3.1 Infectious Disease
16.3.2 Immune‐Related Disorders
16.3.3 Metabolic Diseases
16.3.4 Toxic Conditions
16.3.5 Traumatic Conditions
References
17 Common Situations of Malpractice and Mistakes, and How Best to Avoid Them
17.1 Introduction
17.2 Anesthesia
17.3 Oral Exam and Diagnostics
17.4 Improper Therapy and Iatrogenic Damage
17.5 Client Communication
References and Further Reading
18 Dentistry Through Life : Pediatric and Geriatric Dentistry
18.1 Pediatric Dentistry
18.1.1 Problems of the Teeth
18.1.2 Problems of the Oral Soft Tissues
18.2 Geriatric Dentistry
References
19 Management of the Dental Patient
19.1 Identifying Problems
19.2 First Consultation or Discussion with the pet owner
19.3 Additional Consultations: Internal Medicine, Cardiologist, Neurologist, Anesthesiologist
19.4 Day of Surgery
19.5 Follow‐Up
19.6 What Every Vet Should Know About Dental Problems
19.6.1 Key Points
References and Further Reading
20 Professional Dental Cleaning
20.1 Introduction
20.2 Procedure
20.2.1 Step 1: Presurgical Exam and Consultation
20.2.1.1 Staff and Patient Protection
20.2.2 Step 2: Chlorhexidine Lavage
20.2.3 Step 3: Supragingival Cleaning
20.2.3.1 Mechanical Scaling
20.2.3.2 Hand Scaling
20.2.4 Step 4: Subgingival Plaque and Calculus Scaling
20.2.4.1 Mechanical Scaling
20.2.5 Step 5: Residual Plaque and Calculus Identification
20.2.6 Step 6: Polishing
20.2.7 Step 7: Sulcal Lavage
20.2.8 Step 8: Fluoride Therapy (Optional)
20.2.9 Step 9: Periodontal Probing, Oral Evaluation, and Dental Charting
20.2.10 Step 10: Dental Radiographs
20.2.11 Step 11: Treatment Planning
20.2.12 Step 12: Application of a Barrier Sealant (Optional)
20.2.13 Step 13: Client Education
20.3 Key Points
References
21 Oral and Maxillofacial Surgery : What's the Difference?
21.1 Introduction
21.2 Pain Management
21.3 Infection Control
21.4 Treatment Planning
21.5 Four‐Handed Surgery
21.6 Structures and Anatomy
21.7 Techniques, Instruments, and Materials
21.7.1 Surgical Techniques: Cold Steel, Scissors, Radiosurgery, Laser Surgery, Piezosurgery
21.7.2 Gentle Tissue Handling
21.7.3 Hemostasic Techniques
21.7.4 Line Angles, Access Flaps, and Fenestration of the Periosteum
21.8 Wound Closure
21.9 Biopsy
21.10 Conclusion
References
22 Extraction Techniques and Equipment
22.1 Introduction
22.2 Nonsurgical (Closed) Extractions. 22.2.1 Step 1: Consent
22.2.2 Step 2: Preoperative Dental Radiographs
22.2.3 Step 3: Pain Management
22.2.4 Step 4: Cutting of the Gingival Attachment
22.2.5 Step 5: Luxation and Elevation. 22.2.5.1 Instrument Selection
22.2.5.2 Safety
22.2.5.3 Technique
22.2.5.4 New Mechanical Technique
22.2.6 Step 6: Extraction
22.2.7 Step 7: Debridement, Alveoloplasty, and Augmentation of the Alveolus
22.2.8 Step 8: Postoperative Dental Radiographs
22.2.9 Step 9: Closure of the Extraction Site
22.3 Extraction of Multirooted Teeth
22.4 Surgical (Open) Extractions
22.4.1 Instrumentation. 22.4.1.1 Hand Instruments
22.4.1.2 Power Instruments
References
23 Oral Emergencies
23.1 Introduction
23.2 Selected Topics Related to Oral Emergencies and Maxillofacial Surgery. 23.2.1 Management of Trauma and First Aid in Oro‐Maxillary Injuries
23.2.2 Diagnosis: Physical Examination and Imaging – Establishing the Treatment Plan
23.2.3 Fractures of Orofacial Hard Structures
23.2.4 Damage to the Oral Soft Tissues
23.2.5 Acute and Chronic Problems with Jaw Motion: TMJ Traumatic Problems
23.2.6 Oral and Maxillofacial Complications and Consequences of Head Injury
23.3 Most Common Emergency Procedures. 23.3.1 Tape Muzzle Placement
23.3.1.1 Dogs
23.3.1.2 Cats
23.3.2 Dentinal Bonding. 23.3.2.1 Indications
23.3.2.2 Purpose
23.3.2.3 Steps
23.3.2.4 Follow‐up
23.3.3 Mandibular Symphyseal Separation Management
References
24 Feline Dentistry
24.1 Introduction
24.2 Preoperative Actions
24.3 Perianesthetic Hazards
24.4 Surgery
24.5 Postoperative Challenges
24.6 Imaging and Radiography
24.7 Brachycephalic Breeds
24.8 Oral Neoplasms
24.9 High‐Rise Syndrome
24.10 The Cat‐Friendly Clinic
24.11 Caudal Stomatitis
24.11.1 Etiology
24.11.2 Clinical Signs
24.11.3 Diagnostics
24.11.4 Management
24.11.5 Surgical Therapy
24.11.6 Medical Therapy
24.11.6.1 Antibiotics/Antiseptics
24.11.6.2 Anti‐Inflammatories
24.11.6.3 Cyclosporine
24.11.6.4 Feline Interferon Omega
24.11.6.5 Other Treatment Options
24.12 Tooth Resorption. 24.12.1 Clinical Features
24.12.1.1 Type 1
24.12.1.2 Type 2
24.12.2 Diagnosis
24.12.3 Management
24.13 Feline Orofacial Pain Syndrome (FOPS)
24.14 Juvenile Periodontal Diseases
24.15 Eosinophilic Granuloma Complex
24.15.1 Clinical Features
24.15.2 Management
24.16 Pyogranuloma Secondary to Traumatic Dental Occlusion
24.17 Common Procedures
References
25 A Brief Introduction to Specific Oral and Dental Problems that Require Specialist Care
25.1 Introduction
25.2 Skills and Services
25.3 Cases
25.3.1 Case 1
25.3.2 Case 2
25.3.3 Case 3
25.3.4 Case 4
25.3.5 Case 5
25.3.6 Case 6
25.3.7 Case 7
25.3.8 Case 8
25.3.9 Case 9
25.3.10 Case 10
25.3.11 Case 11
25.3.12 Case 12
25.3.13 Case 13
25.3.14 Case 14
25.3.15 Case 15
25.3.16 Case 16
25.3.17 Case 17
25.3.18 Case 18
25.3.19 Case 19
25.3.20 Case 20
Further Reading
26 How to Cooperate with a Specialist
26.1 Introduction
26.2 What You Should Do
26.3 What to Expect from the Specialist
26.4 Conclusion
Useful Algorithms for the Management of Oral Problems
Oral Health Index. Ranking of evaluated parameters identified during oral cavity assessment and interview
Periodontal diseases 1
Periodontal diseases 2. color code
High Rise Syndrome or Head injury. color code
Teeth injuries. color code
Pulp disease. color code
Oral mass
Orthodontics. color code
Inflammatory feline oral diseases. color code
Teeth resorption. color code
Appendix A Drugs and Doses
Anti‐inflammatory Drugs
Analgesics
Anesthetics/Sedatives
Appendix B Instruments Handling and Sharpening
B.1 Introduction
B.2 Sterilization
B.3 Sharpening
B.4 Maintenance of Power Equipment. Radiography Equipment
Ultrasonic Scalers
Handpieces
Compressor
References
Appendix C Abbreviations and Dental Charts
Dental Charts
Appendix D List of Hereditary Problems and Breed Predispositions in Dogs and Cats
Appendix E Tolerance of Malocclusion and Dental Abnormalities in Dogs
Appendix F Assisted Feeding in Dental Patients
F.1 Change in Food Texture
F.2 Tube Feeding
F.3 Evaluation of Nutritional Needs of Animal
F.4 Nutritional Challenges in Veterinary Dental Patients
References
Index. a
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e
f
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